1
|
Sato K, Funayama T, Noguchi H, Kumagai H, Kikuchi N, Yoshioka T, Koda M, Yamazaki M. Effect of platelet-rich plasma on the acceleration of graft bone catabolism in lateral lumbar interbody fusion in a short-term assessment. J Artif Organs 2024; 27:247-252. [PMID: 37794211 DOI: 10.1007/s10047-023-01418-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/08/2023] [Indexed: 10/06/2023]
Abstract
This study aimed to demonstrate whether impregnating the graft bone with platelet-rich plasma (PRP) accelerates graft bone catabolism in lateral lumbar interbody fusion (LLIF). Consecutive patients who underwent LLIF were assessed. Of the two spaces for bone grafts in the intervertebral cage, one space was filled with graft bone impregnated with PRP, and the other was filled with graft bone without PRP, which divided the graft bones into PRP and non-PRP groups. The mean Hounsfield units (HU) of the graft bone at the center of the cage space in the coronal and axial slices were measured using computed tomography (CT) images 1 week and 6 months after surgery. The delta value of HU from 1 week to 6 months after surgery was calculated for the PRP and non-PRP groups. We compared the delta values of the HU between the two groups. The PRP and non-PRP groups comprised 16 bone grafts. In the coronal slices, the HU value in the PRP group (delta value: 526.1 ± 352.2) tended to have a greater decrease at 6 months after surgery compared with that in the non-PRP group (delta value: 217.6 ± 240.4) (p = 0.065). In the axial slices, the HU value in the PRP group (delta value: 501.3 ± 319.6) was significantly decreased at 6 months after surgery compared with that in the non-PRP group (delta value: 159.2 ± 215.3) (p = 0.028). Impregnating the graft-bone with PRP accelerated graft bone catabolism in LLIF within 6 months after surgery.
Collapse
Affiliation(s)
- Kosuke Sato
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Toru Funayama
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroshi Noguchi
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroshi Kumagai
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Naoya Kikuchi
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Tomokazu Yoshioka
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| |
Collapse
|
2
|
Wang H, Zhu J, Xia Y, Li Y, Fu C. Application of platelet-rich plasma in spinal surgery. Front Endocrinol (Lausanne) 2023; 14:1138255. [PMID: 37008931 PMCID: PMC10057539 DOI: 10.3389/fendo.2023.1138255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
With the aging of the population and changes in lifestyle, the incidence of spine-related diseases is increasing, which has become a major global public health problem; this results in a huge economic burden on the family and society. Spinal diseases and complications can lead to loss of motor, sensory, and autonomic functions. Therefore, it is necessary to identify effective treatment strategies. Currently, the treatment of spine-related diseases includes conservative, surgical, and minimally invasive interventional therapies. However, these treatment methods have several drawbacks such as drug tolerance and dependence, adjacent spondylosis, secondary surgery, infection, nerve injury, dural rupture, nonunion, and pseudoarthrosis. Further, it is more challenging to promote the regeneration of the interstitial disc and restore its biomechanical properties. Therefore, clinicians urgently need to identify methods that can limit disease progression or cure diseases at the etiological level. Platelet-rich plasma (PRP), a platelet-rich form of plasma extracted from venous blood, is a blood-derived product. Alpha granules contain a large number of cytokines, such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), epidermal growth factor, platelet factor 4 (PF-4), insulin-like growth factor-1 (IGF-1), and transforming growth factor-β (TGF-β). These growth factors allow stem cell proliferation and angiogenesis, promote bone regeneration, improve the local microenvironment, and enhance tissue regeneration capacity and functional recovery. This review describes the application of PRP in the treatment of spine-related diseases and discusses the clinical application of PRP in spinal surgery.
Collapse
|
3
|
Sato K, Funayama T, Noguchi H, Asada T, Kono M, Eto F, Shibao Y, Miura K, Kikuchi N, Yoshioka T, Takahashi H, Koda M, Yamazaki M. Efficacy of platelet-rich plasma impregnation for unidirectional porous β-tricalcium phosphate in lateral lumbar interbody fusion: study protocol for a prospective controlled trial. Trials 2022; 23:908. [PMID: 36303197 PMCID: PMC9615172 DOI: 10.1186/s13063-022-06857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of platelet-rich plasma has been increasing in spinal fusion surgery. However, the efficacy of platelet-rich plasma in lateral lumbar interbody fusion is unclear. In Japan, Affinos,® (Kuraray Co., Tokyo, Japan), a β-tricalcium phosphate artificial bone, has been increasingly used for spinal fusion. The purpose of this trial is to demonstrate whether Affinos® impregnated with platelet-rich plasma can achieve a higher fusion rate and better clinical outcomes than Affinos® alone. METHODS The current study is a prospective randomized controlled trial. This trial will include consecutive patients scheduled for lateral lumbar interbody fusion. An intervertebral cage for lateral lumbar interbody fusion has two spaces for bone grafts. As a consequence, two bone grafts are inserted at each intervertebral level. In this study, an artificial bone with platelet-rich plasma will be inserted into one space, and an artificial bone without platelet-rich plasma will be inserted into the other space. We will compare the fusion rates between the bone grafts with and without platelet-rich plasma. Our primary endpoint will be the interbody fusion rate at 1 year after surgery. DISCUSSION This trial will verify the efficacy of platelet-rich plasma with Affinos® for bony fusion in lateral lumbar interbody fusion. It will also provide substantial evidence for the effectiveness and safety of platelet-rich plasma in spinal fusion surgery. TRIAL REGISTRATION Japan Registry of Clinical Trials (jRCT) jRCTb032200199 . First registered on 13 November 2020. jRCT is approved as a member of the Primary Registry Network of WHO ICTRP.
Collapse
Affiliation(s)
- Kosuke Sato
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Toru Funayama
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Hiroshi Noguchi
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Tomoyuki Asada
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Mamoru Kono
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Fumihiko Eto
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Yosuke Shibao
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Kosei Miura
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Naoya Kikuchi
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Tomokazu Yoshioka
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Hiroshi Takahashi
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Masao Koda
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| | - Masashi Yamazaki
- grid.20515.330000 0001 2369 4728Department of Orthopedic Surgery, University of Tsukuba, 2-1-1 Amakubo, Tsukuba City, Ibaraki, Japan
| |
Collapse
|